SOMBABU N MAGANTI (NPI# 1407142474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407142474 |
| Entity Type | Individual |
| Full Name | SOMBABU N MAGANTI |
| Credential | M.D |
| Practice Address |
2115 S Fremont Ave Ste 3000 Springfield MO 65804-2239 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 4178203911 |
| Practice Fax Number | 4178203924 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2012-03-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
2011022935 | MO | Allopathic & Osteopathic Physicians |
| N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
25MA08817500 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1407142474 | 05 | |
| MO | RR MCR | P00990413 | 01 |
| AR | 188731001 | 05 |
| Street Address |
2115 S FREMONT AVE STE 3000 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383543 | Steven K Bowlin | Internal Medicine | 2115 S Fremont Ave, Ste 2300, Springfield, MO 65804-2239 | 2005-08-11 |
| 1932656535 | Jill Cotner | Registered Nurse | 2115 S Fremont Ave, Ste 3300, Springfield, MO 65804-2239 | 2016-09-01 |
| 1427437185 | Ashleigh D. Gentles | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2015-05-27 |
| 1063805489 | Chad D. Holland | Physician Assistant | 2115 S Fremont Ave, Suite 5000, Springfield, MO 65804-2239 | 2015-03-10 |
| 1609267731 | Chrystal M. Killinger | Nurse Practitioner | 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804-2239 | 2015-02-11 |
| 1497145767 | Joshua Steven Reece | Physician Assistant | 2115 S Fremont Ave, Ste 5000, Springfield, MO 65804-2239 | 2015-01-26 |
| 1154724144 | Melissa Diane Grisaffe | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2014-10-03 |
| 1790102366 | Breanna R. Burks | Physician Assistant | 2115 S Fremont Ave, Ste 4300, Springfield, MO 65804-2239 | 2014-03-21 |
| 1154745537 | Tarrah Divine | Nurse Practitioner | 2115 S Fremont Ave, Ste 4300, Springfield, MO 65804-2239 | 2014-02-06 |
| 1831539428 | Lacy A. Schnelle | Registered Nurse | 2115 S Fremont Ave, Suite 4300, Springfield, MO 65804-2239 | 2013-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750941639 | Ammar Tarabichi | Psychiatry & Neurology | 751 N Rutledge, Springfield, Il, Springfield, IL 62794 | 2019-06-13 |
| 1316441470 | Earl Randolph Hackett | Psychiatry & Neurology | 2517 S. Brentwood, Springfield, MO 65804-3201 | 2018-03-22 |
| 1336668326 | Western Mass Neurology PC | Psychiatry & Neurology | 175 Carew St Ste 140, Springfield, MA 01104-2389 | 2017-09-12 |
| 1407111313 | Pavan Tummala | Psychiatry & Neurology | 3800 S National Ave Ste 900, Springfield, MO 65807-5209 | 2012-07-06 |
| 1194083105 | Mersedeh Bahr Hosseini | Psychiatry & Neurology | 3311 Riverbend Dr., Neurohospitalists, Springfield, OR 97477 | 2012-04-26 |
| 1053553560 | Quantum Total Health | Psychiatry & Neurology | 607 S Locust St, Springfield, TN 37172 | 2009-03-30 |
| 1154513687 | Fazeel Mukhtar Siddiqui | Psychiatry & Neurology | 751 N Rutledge St Ste 3100, Springfield, IL 62702-4968 | 2007-08-17 |
| 1164593646 | Michael Balm | Psychiatry & Neurology | 1 Hayden Bridge Way Ste 410, Springfield, OR 97477-1347 | 2006-11-13 |
| 1881638591 | Rodney D Quinn | Psychiatry & Neurology | 3801 S National Ave # 900, Springfield, MO 65807-5210 | 2006-06-15 |
| 1750332771 | Sleep Medicine Services of Western Massachusetts LLC | Psychiatry & Neurology | 3640 Main St Ste 208, Springfield, MA 01107-1192 | 2006-05-15 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.